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Camp Ramah's Tikvah Program Articles

A Specialized Program for Children with Developmental Disabilities within a "Typical" Overnight Summer Camp: Camp Ramah's Tikvah Program
May 1, 2007 by Howard Blas

Specialized summer camp programs for disabled children began to emerge in the late 19th century and expanded in the 1930’s and 40’s [1]. Although it is not known when integration of children with developmental disabilities into “regular” camps began, it is likely to have been pioneered in camps operated by religious organizations [2]. The first Jewish summer camp to offer an overnight camping option to campers with special needs was Camp Ramah in New England (CRNE), which initiated the Tikvah Program in 1970. The Tikvah Program (from a Hebrew word meaning “Hope”), is an eight-week overnight camping program operating within Camp Ramah, and includes campers with developmental disabilities such as mental retardation, autism spectrum disorders, and neurological impairments.

There are many special considerations, challenges and modifications necessary in designing and operating a program for campers with developmental disabilities. These will be discussed in the context of the Tikvah Program at CRNE.

Camp Ramah
CRNE, a summer camp for typically developing children ages 8 through 16, is located in Palmer, Massachusetts. It is one of ten Ramah camps affiliated with the Jewish Conservative Movement. At Camp Ramah, Jewish living and learning and Hebrew language are an intentional part of every aspect of the camp day and camp life. A typical day includes Hebrew language and Jewish content classes, sports, swimming, singing and dancing, and arts and crafts. There are also elective activities including woodworking, archery, boating, video, and a ropes course.

The Hebrew language is inextricably bound into the fabric of the daily life at camp. Announcements in the dining room and at all camp-wide functions are delivered in Hebrew. The weather forecast and sports results are announced in Hebrew, and signs in Hebrew identify everything from building names to the dining room menu.

World-wide, Ramah camps employ more than 1,500 university students as counselors and offer camping programs to more than 6,500 campers each summer. The National Ramah Commission oversees seven overnight camps and three day camps throughout the United States, Canada, and Israel. Ramah-style camps also operate in the Ukraine, Argentina, England and Spain.

History of the Tikvah Program at Camp Ramah
The Tikvah Program at CRNE was founded by Herb and Barbara Greenberg [3], schoolteachers and experts in special education. The idea of a camping program for Jewish adolescents with special needs was first proposed in the late 1960’s by the Commission on Jewish Education of the United Synagogue of America. Various Jewish camps rejected the proposal to enroll a group of adolescents with developmental disabilities in their own camp, citing fears of anxiety among campers and staff as well as a threatened decrease in enrollment.

Through the persistence of the Greenbergs, Camp Ramah established the Tikvah Program in 1970. In its first year, the program enrolled eight campers classified by their respective school systems as “brain-injured,” “learning disabled,” and “emotionally disturbed.” Over the years, it has enrolled children and adolescents with Down Syndrome, autism, neurological impairments, developmental delays, and rare disorders such as Smith-Magenis and Prader-Willi Syndromes.

Other Ramah camps have followed the lead of the CRNE Tikvah Program. In 1973, a second Tikvah Program was founded at Camp Ramah in Conover, Wisconsin. In the early 1980’s, a third program was started at Camp Ramah in Ojai, California and soon after, a fourth program was initiated at Camp Ramah in Canada.

In more recent years, Camp Ramah in the Berkshires has instituted the Breira Program, a full-inclusion program for younger campers with social skills deficits. Camp Ramah Darom (Georgia) has twice run a one-week encampment for children with autism and their families. A day camping program is scheduled to open at Camp Ramah in Nyack, New York in 2008.

While serving as a model for other Ramah camps, the Tikvah Program at CRNE continues to be the largest of Ramah’s Tikvah Programs and includes campers with the widest range of special needs.

Camp Ramah in New England: admission and screening
While CRNE accepts typical children between the ages of 8 and 16, Tikvah campers begin camp at age 13. After age 18, some campers are invited to participate in the Vocational Training Program, where they may remain until graduation from high school at ages 21 or 22. Some campers (who have not been promoted to Voc Ed) may remain in the camping program beyond age 18.

Applicants for the Tikvah program are carefully screened. Applications for the regular CRNE program may be downloaded from the camp website, and in most instances, admission is automatic [4]. In contrast, the Tikvah application process involves a thorough assessment, which is crucial in determining the goodness of fit between the camper and the program. The process begins with phone screening, followed by review of an extensive admissions packet including a copy of the child’s Individualized Educational Program (IEP), as well as copies of neuropsychological, speech and language, and occupational and physical therapy evaluations. The applications also includes written assessments by three teachers. In many cases, the Tikvah Director contacts teachers and therapists to discuss the applicant. The CRNE director, the head of the infirmary, the consulting psychiatrist, and others are consulted as needed on issues such as unusual accessibility accommodations, medical, or psychiatric challenges.

The application process culminates in a personal interview with the child and parents. The interview allows the director an opportunity to see and interact with the camper, and is an opportunity for parents to ask questions and gain the trust of the Tikvah Director, the person who will be ultimately responsible for their child’s care for eight weeks. The family is notified of acceptance status within several days of the interview.

Camp structure and flow of the day
At Ramah camps, the day is divided into eight 50 minute periods. Younger campers have a predictable, structured program with limited free time and minimal input into their schedule. As campers get older, they have more free time, more input into their program (they can play on sports teams, learn to be life guards, and so forth), and they participate in service projects.

The structure and predictable nature of each camp day is beneficial to all campersdespecially those with special needs. The schedule of activities followed by the Tikvah campers, with minor modifications, is identical to the schedule followed by the other divisions in camp. Following wake up, all Ramah campers and staff members attend prayer services, which are held by division and last forty five minutes. At the conclusion of Tikvah services, the division head, often assisted by campers, announces the daily schedule. Campers are so familiar with and dependent upon the schedule that this “recitation ritual” consists of campers “calling out” in unison the hour-by-hour schedule of the day. Any anticipated deviations from the regular schedule (i.e., likely cancellation of swimming due to a thunderstorm) are announced at this time to adequately prepare campers for such a change.

Tikvah campers benefit from knowing the daily schedule in advance. All Tikvah bunks have a large calendar posted on the door. Each camper also has a smaller schedule taped near his bed, and some Tikvah campers carry around smaller printed versions of the daily schedule.

After morning services, the entire camp eats breakfast in the dining room. Bunk clean-up takes place after breakfast. There are then three morning periods, followed by lunch. Over the years, the Tikvah schedule has been repeatedly revised and fine-tuned. For example, Tikvah campers no longer swim the first period of the day, when the water temperature is cool; rather, they swim third period–just before lunch–when the water temperature is warmer. The proximity of the swim period to lunch allows campers to return to their bunks to change out of their wet bathing suits. One or two campers may shower during this time, easing evening “crowding” for the two bunk showers. The Tikvah schedule also reflects the camper’s need for balance throughout the day. For example, Tikvah campers may move from a more to a less physically active session, or from an outdoor to an indoor activity. Or, they may have a whole-group activity one period, and break into smaller groups the next.

During the 60 minute rest period following lunch, campers return to their bunks where they socialize quietly, write letters, listen to music, play board games, throw a ball or Frisbee, or take a nap.

The three morning periods for the Tikvah Program include singing and dancing, a Jewish Studies class and swimming. The four afternoon periods typically consist of sports, pre-vocational training, arts and crafts, a buddy program with the 14 year old division, and electives such as boating, photography, archery, drama and woodworking.

After the last afternoon period, everyone eats dinner and participates in a short evening activity with their own division. There are several camp-wide evening activities held throughout the summer. For example, each division including Tikvah prepares and presents a Hebrew-language play for the entire camp, performs in a Hebrew song and dance festival, and participates in the camp color war.

At the conclusion of the evening activity, campers return to their bunks and have a curfew, which varies by age. Tikvah campers generally require more sleep and welcome the opportunity to return to their bunks relatively early in the evening for showers and a night time winding down ritual, which may consist of story time or music. On Saturday night, some Tikvah campers participate in Israeli dancing with older campers from other divisions. All Tikvah campers are expected to remain in their bunks quietly after lights are out.

Schedules and predictability
Before the summer, the camp director, division heads and department heads carefully work out a master camp schedule, charting each division’s order of rotation through daily activities. For typical (non-Tikvah) campers, the schedule is generally viewed as fair, with a reasonable balance between structured periods and free time. While some campers would prefer additional free time, other campers (especially younger ones) have difficulties managing unstructured time.

Tikvah campers require more structure and predictability than typical campers. Wednesdays and Saturdays, which deviate from the normal schedule, are particularly challenging for Tikvah campers. On Wednesdays, all teachers and specialists are off and each division is responsible for its own structuring of the day and activity planning. Counselors therefore plan activities which will provide more structure to the day. On Wednesdays, Tikvah counselors plan a theme-day and may also offer a special activity such as a water fight or ice-cream party.

The Jewish Sabbath, from Friday evening through Saturday night is a special time in camp. Following lunch on Friday, the entire camp prepares for the Sabbath with bunk and field clean up. On Friday evenings, the entire camp comes together in a pine grove for Sabbath evening programming. Each week, a different division (including Tikvah) performs a song and dance, and two divisional representatives lead the camp in prayer. All campers and staff members are required to wear dressier attire to Sabbath services and Friday night dinner. On Saturdays, campers have a late wake up. Breakfast is followed by morning prayer services. Campers have an hour or more of free time, followed by lunch and more free time. Tikvah campers participate in optional free swim, play board games, play informal sports activities, or watch one of the staff sports games.

While Wednesdays and Saturdays are days where departures from the daily schedule are anticipated in advance, even “regular days” can have unexpected changes. When staff members are aware of changes in schedule ahead of time (for example, cancellation of a dance class when the instructor is out of camp), they are announced immediately. Campers can thus begin to process the information. If a change seems possible or likely (i.e., when the forecast of an impending thunderstorm may cancel boating), this information is also shared with campers. There are times when (last minute) changes to the schedule cannot be anticipated, and campers and counselors must deal with this situation. Knowing of changes in advance is preferable as it helps minimize disappointment and upset.

Medical issues and medication management
The infirmary sees campers and staff daily during “sick call” and on an emergency basis. Campers typically present with sprains, cuts, stomach aches, fevers, sore throats, bug bites, and rashes. Tikvah campers tend to present with similar medical issues; however, there are special issues unique to the Tikvah campers. Tikvah campers tend to both underreport and over report illness and other concerns. Some campers have a very high tolerance for pain, and many campers lack the language ability to report discomfort. On the other hand, some campers enjoy secondary gain by frequenting the infirmary. Given that many Tikvah campers have seizure disorders, food allergies, and often complicated medical histories, counselors are taught to monitor campers for behavioral changes, to always keep campers hydrated and to maintain a low threshold for bringing the camper to the infirmary. In some cases, the Tikvah director facilitates consultations with psychiatrists, neurologists, psychopharmacologists, and other experts.

More than 100 staff members and non-Tikvah campers come to the infirmary for daily prescription medications. Most Tikvah campers take standing medication between one and four times per day. A nurse, accompanied by the Tikvah Director or the division head, dispenses medication in the dining room (at the camper’s table), in the camper’s bunk, or in the Tikvah program lounge.

Parents are informed during the admissions process that Ramah is a summer camp and not a treatment center. Nonetheless, accommodations are made for campers who need ongoing therapies. Some families (especially those of children with cerebral palsy) have arranged for physical therapists to work with their child. Other families have hired speech and language therapists. The Tikvah Director coordinates such visits and arranges for a treatment space. Educational tutoring is not offered by the camp, though several campers have worked on academic skills with peer or staff “buddies” during free periods.

Inclusion opportunities at the Tikvah Village
The Tikvah Village consists of four bunks (two male, two female) and a large multi-purpose room. Tikvah bunks are the only handicapped accessible bunks at camp.

The bunks are spacious (allowing more room per camper than in typical bunks), well-lit (fluorescent lighting in the sleep areas and bathrooms), and fully wheelchair accessible. Bathrooms have handicapped-accessible toilets and showers and grab bars, and each bunk has two doors, a spacious porch and a ramp. Window air conditioning units keep campers cool during rest period and other bunks times.

The Tikvah Village was intentionally constructed on the edge of “B-Side” of camp, home to the 13-16 year old campers. ("A-Side,” a ten minute walk from B-Side, houses the 8-12 year old campers). Many classes, electives and camp-wide activities take place in the pine grove and in buildings just behind the Tikvah bunks. Thus, socialization and interaction between Tikvah and non-Tikvah campers occur as campers walk past Tikvah bunks, en route to divisional or camp-wide activities.

Interaction also takes place on the Tikvah bunk porches and in the area in front of the Tikvah bunks. The Tikvah bunks are the only bunks in camp which offer covered porches. During inclement weather, the porches become places for campers from various divisions to socialize, listen to music, and play board games, thereby increasing inclusion opportunities for Tikvah campers. In addition, a nearby basketball court also encourages socialization among differently abled campers.

Tikvah campers, under the direction of a professional horticulturist, designed and constructed garden boxes (some elevated for campers in wheelchairs), located in front of each Tikvah bunk. Campers maintain the various flower, herb and vegetable gardens. Campers and staff members from around camp enjoy the gardens, which offer a pleasant backdrop for conversations. Tikvah campers harvest vegetables and herbs (for use in our cooking program), and pick flowers which are given to friends or used as decorations.

Opportunities for interaction
The design and location of the Tikvah Village foster interaction with the camp community. Campers and staff members share the camp with the Tikvah Program and see Tikvah campers throughout the day–on walkways, ball fields and classrooms, in the dining room, and at all camp-wide activities. Observing Tikvah campers at camp-wide activities can be quite powerful and instructive to members of the camp community. For example, when Tikvah campers compete in the camp-wide sports day, campers in other divisions sometimes see how fast or skilled at volleyball or softball a person with disabilities can be. At a recent song and dance festival, a member of the Tikvah Program, who has been taking dance lessons for many years, performed a solo tap dance for the entire camp.

Although there are numerous occasions when informal interactions take place between Tikvah and the rest of the camp community, there are also more formal opportunities for campers and staff to become involved with Tikvah campers. The youngest Ramah campers are entering third graders who attend camp for a two week mini-session. The young campers visit with members of the Tikvah Program and tour the Tikvah bunks as part of their Jewish Studies curriculum on the theme of being created “In God’s Image.” This curriculum focuses on similarities and differences between human beings. Tikvah counselors visit their bunks the evening before their visit to answer questions.When the campers experience the Tikvah Village, they have an opportunity to walk up the ramp, hold the grab bar in the bathroom, and sit on the shower chair. The campers compare and contrast these bunks to their own. They are often envious of the spacious, climate-controlled bunks!

Campers in the 9-12 year old divisions interact with Tikvah campers through participation in counselor-planned activities, such as an evening game, prayer service, or Sabbath free-time activity. Younger campers typically enjoy many of the same types of activities as the Tikvah campers. They tend to be open and accepting, and sometimes have prior experience with children with special needs, the result of inclusion programs in their schools.

Campers in the 13-16 year old divisions often study rabbinic sources dealing with disabilities in their Jewish Studies classes and participate in a dialogue with a panel of Tikvah campers and graduates. They have the opportunity to plan an activity for Tikvah campers, and may spend some time working in the Tikvah Program. Twelve and thirteen year old campers have volunteered to write letters or read with Tikvah campers during rest period.

Fourteen year old campers may participate in a formal buddy program. Each camper electing to be a “buddy” spends 45 minutes twice a week socializing one-on-one with a Tikvah camper. Fifteen year old campers may volunteer to be “peer helpers” to the Tikvah campers during their daily sports and swimming periods. Sixteen year old campers may choose to work with 9-12 year old or Tikvah campers as part of their counselor-in-training (CIT) experience. The CITs learn skills required to serve campers with special needs, and work two full days per week with their Tikvah bunk. They are particularly helpful during difficult periods such as wake up time, rest period, and bedtime. While CITs may exhibit more typical 16 year old behavior in their own divisions, they tend to display responsible behavior in their CIT role, modeling appropriate dress, demeanor, and language for the Tikvah campers. Parents of Tikvah campers are always pleased that their children have opportunities to interact extensively with more typically developing teenagers.

While Tikvah campers are clearly the recipients of the assistance and coaching offered by peers from other divisions, it is important to emphasize that the relationships are beneficial to typically developing campers as well. Such direct involvement with campers with special needs tends to demystify this population. Volunteering elicits good performance among the teenagers, who often feel proud that they have succeeded in what may have appeared to be a difficult area. The behavior extends beyond camp; often the teenagers choose to donate money to the Tikvah Program as part of a social action project, or perform additional community service with a similar population in their home communities. Many former “buddies” and CITs have returned to camp to serve as counselors in the Tikvah Program.

Vocational education program
Select graduates of the camping program are invited to live in a group home-like setting with responsibilities for laundry, cleaning, light cooking and kitchen chores. Each participant works at a job in camp and receives vocational training from a job coach. Some graduates of this program are hired as salaried workers of camp. Several members of the Post-Voc Ed Program operate and maintain the newly constructed, six-unit guest house, which houses camp guests in a hotel-like atmosphere. Other Post-Voc Ed employees work in the art department, the mail room, and the library. These graduates live in staff housing and continue to work with a job coach, receiving supports around problem solving, socialization issues, and negotiating days off.

Tikvah staff training and support
Most of the counselors in the Tikvah program had attended CRNE as campers and are familiar with the Tikvah program. Many have a career interest in special education, social work, psychology, pediatrics or physical, occupational or speech and language therapy.

First year Ramah counselors are typically 17 or 18 years olds, and go through an extensive interview process. In general Tikvah counselors are consistently respected and admired throughout CRNE, mainly for their dedication, hard work, compassion and ability to work with the disabled population.

Most of the formal training occurs during Staff Week, a six day training session conducted immediately before the start of the camp session in June. During Staff Week, they engage in team building exercises, participate in didactic sessions with the Tikvah Director, and learn through peer teaching sessions on topics relevant to the special needs population. In addition, Tikvah staff meet to learn about each camper in detail, discuss special medical and behavioral issues, and plan the schedule. Outside experts and parents of Tikvah campers also meet with the Tikvah staff. In recent summers, visitors included a camper’s behavior therapist, a speech and language therapist, the mother of a child with Down Syndrome who is also hard of hearing (to introduce a picture communication system), and the parents of a child with Prader-Willi Syndrome (to share special dietary and food management issues). Staff week visits by parents, especially when accompanied by the camper, help facilitate staff-camper relationships.

During Staff Week, Tikvah staff members also join other CRNE staff members in training sessions focusing on policies and procedures and general counselor skills. Throughout the summer, counselors meet with the division head for weekly training and feedback sessions. In addition, the entire staff meets formally with the Director once a week. The Tikvah Director and division head closely monitor camper and staff issues and offer guidance, strategies and advice.

In the typical CRNE camping program, there is generally one counselor per four or five campers. The ratio of Tikvah staff to camper is approximately one to two or two and a half. The cost for attending the eight week Tikvah Program is slightly higher than the cost of the typical eight week camping program. Scholarships are available.

Collaboration and communication with parents and outside support team members
Beginning with the first call from parents to the Tikvah Director to inquire about the program, a tone of collaboration is set. Parents are informed that the process of deciding on the suitability of camp will be a collaborative, team effort. Parents are encouraged to accurately share all information about their children and to raise their concerns. Parents sometimes express concerns about having their child away from them for two months, and they worry about such issues as medication, medical care and meals.

Throughout the summer, parents will receive letters from their children. The camp requires that all campers write at least two letters per week; Tikvah counselors try hard to make sure Tikvah campers write home at least once per week. Given the difficulties Tikvah campers have with writing, and with expressing themselves in writing, the letters are not always informative. The Tikvah Director therefore sends a weekly email update to the parents, informing them of daily activities, special trips, etc. In turn, parents ask appropriate follow up questions in letters to their children.

The Tikvah director is available 24 hours a day by cell phone and computer, and he frequently calls parents to share nice stories or observations, or to ask for help in managing a particular behavior. Consultations with therapists and teachers are similarly helpful.

During the winter months, communication continues between parents and the Tikvah Director. Families frequently consult with the Tikvah Director as they apply for school programs, vocational training programs, college programs, and group residences. The Director frequently writes recommendations and letters in support of campers, calls directors of admissions, and puts families in contact with other current or past Tikvah families who are dealing with similar issues.

One or two reunions and parent seminars are offered during the year in a location geographically convenient for the majority of Tikvah families. A two day Parent Conference is planned for the summer and guest speakers will conduct workshops on such topics as planning for the years beyond graduation from high school.

Early termination
Campers in typical CRNE divisions occasionally leave early or are dismissed for violations of camp policies (such as drug use) or medical reasons. In the Tikvah program, despite the careful screening process, campers have been terminated from the program for a variety of reasons. As part of the admissions process, families are informed that campers with psychiatric difficulties are not admitted to the program. Although these instances are rare, campers have been sent home for reasons including running away, violence toward others, self-injurious behavior, sexually inappropriate behavior, and psychosis.

Growing and changing with the times - current and future directions
The Tikvah Program has evolved a great deal since 1970 along with society’s attitudes toward people with developmental disabilities. When the program was started, the concept of “mainstreaming” was new. Many in the camp worried about the presence of campers with special needs and were reluctant to work with them. Over the years, Tikvah campers have ranged from possessing learning disabilities and socialization issues, to having developmental disabilities, to having mild mental illness. Presently, the Tikvah program mainly serves children with developmental disabilities.

Campers with a range of other special issues, including learning disabilities (including nonverbal learning disabilities), attention deficit hyperactivity disorder, Tourette’s syndrome, language processing issues, and social skills deficits are supported now in more typical divisions. Parents of these campers speak to the camp director or Tikvah director before submitting an application to discuss the possibility of their child attending camp and to discuss the types of support needed to succeed in camp. In cases where families fail to notify the camp about these issues, proper supports are not put in place, bunk and divisional staff are unprepared, and a feeling of resentment often exists.

Developments in the field and in the lives of children and families with special needs encourage the program to challenge its established practices and consider additional programs and models of service delivery. When families of current and prospective campers began raising questions about Tikvah’s “separateness” from same-age peers in typical divisions, the camp explored the possibility of starting an inclusion program. A small, grant-funded, inclusion program for campers too young for Tikvah, was started three years ago. Such a program allows same-age campers (with and without identified disabilities) to begin camp together, at a young age. Professor Spencer Salend of the State University of New York at New Paltz, an expert on inclusive classrooms, serves as a consultant to the inclusion program. Long term results have not been studied. Anecdotally, the social gap seems to widen as campers get older. The camp continues to carefully monitor each inclusion camper and each bunk and division. Each inclusion camper continues to participate in a carefully constructed, individualized program.

The Tikvah Program is also examining its age of graduation. While graduation from high school (at 21 or 22, depending on home school district) was always considered to be the “end point” for eligibility in Tikvah, it is increasingly apparent that campers can continue to benefit from the program, beyond a “fixed” chronological age. In addition, many campers with “developmental delays” exhibit uncanny growth in their late teens and early twenties.

Summary
When the Tikvah Program was first created, there were few overnight camping programs, providing services to campers with special needs, housed within and a full part of a regular summer camp. Now, after 37 years, the Tikvah Program at CRNE is an integral part of camp. It is clear that the Tikvah Program offers opportunities and benefits for all members of the Ramah community. Nonetheless, such a program also presents special issues and challenges. The program continues to grow and evolve to meet these challenges and the changing needs of special needs populations.

References
[1] Eells E. The movement spreads out. In: History of organized camping: the first 100 years. Martinsville (IN): American Camping Association; 1986. p. 99–116.
[2] Blake J. Opening doors: integration of persons with a disability in organized children’s camping in Canada. Journal of Leisurability 1996;23(2):1–9.
[3] Greenberg H, Greenberg B. Tikvah means hope. In: Dorph SA, editor. Ramah reflections at 50: visions for a new century. New York: National Ramah Commission; 1999. p. 139–54.
[4] Camper Application Form. Available at: http://www.campramahne.org Accessed January 1, 2007.
Filed under: Special Articles, Tikvah Articles